Mary T Sheppard, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F380546 Issued in NY

Practice address

1001 Main St FL 4
Buffalo, NY 14203-1009

Phone

(716) 323-0110

Fax

(716) 323-0296

NPI assigned

Apr 24, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Allentown Pediatric and Adolescent Medicine

  • Pediatric Adolescent Medicine Physician
  • Buffalo, NY
  • NPI 1598729808
  NPD (past)
• General Physician, PC

  • General Practice Physician
  • Dunkirk, NY
  • NPI 1093959322
  NPD (past)
• University at Buffalo Pediatric Associates Inc

  • Pediatrics Physician
  • Buffalo, NY
  • NPI 1912928599
  NPD (past)
• Wells Gastroenterology PLLC

  • Gastroenterology Physician
  • Amherst, NY
  • NPI 1144391772
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1417913096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0110",
            "fax_number": "716-332-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST FL 4",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031009",
            "telephone_number": "716-323-0110",
            "fax_number": "716-323-0296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1404 Sweet Home Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NY",
            "postal_code": "142282778",
            "country_code": "US",
            "telephone_number": "716-639-9360",
            "fax_number": "716-323-0296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "MARY",
        "middle_name": "T",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-24",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F380546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02344723",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "071112000039",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "080407000110",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lata Shenoy
• Niraj Konchady Shenoy, M.D., PH.D.
• Marisa N Shepherd, CASAC
• Rebecca Barnes Shepherd, RPA-C
• Anthony Sheppard, MS
• Sandra Sheppard
• Tenzin Sherab, CRNA
• Michael James Sherburne, MD
• Grace Ann Sherer, PA
• Bassem Sherif, M.D.

• Pediatric Nurse Practitioner in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.